title: Frequency and treatment of methicillin resistant Staphylococcus aureus in obstetric and gynaecological sepsis.
abstract: OBJECTIVE
  To perform culture and sensitivity for pathogens causing puerperal and postoperative wound sepsis and determine the frequency of Methicillin Resistant Staphylococcus aureus (MRSA) in such infections.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Obstetrics and Gynaecology Ward, Jinnah Postgraduate Medical Centre, Karachi, from December 2008 to May 2010.
  
  
  METHODS
  All patients presenting with puerperal sepsis or postoperative wound infection were enrolled. Pus was collected for culture and sensitivity using standard technique. Two samples were taken from each patient; one before starting the treatment and one at the end of treatment. Ames transport medium was used. Empirical treatment with triple regimen (Ampicillin, Metronidazole and Gentamicin) was started immediately to cover Gram positive as well as negative bacteria in addition to anaerobic infection. After receiving the sensitivity report, antimicrobial agent were changed accordingly. Samples from ward and theater staff and environment were also taken to look for possible mode of transmission. Data was recorded on a proforma. Discrete variables are expressed as percentages.
  
  
  RESULTS
  Staphylococcus aureus was the most frequent organism isolated in 34.6% cases. Methicillin sensitive Staphylococcus aureus was seen in 20% cases and methicillin resistant Staphylococcus aureus was seen in 14.6%. Out of these 14.6% MRSA, (17) 77% was associated with puerperal sepsis and rest (5) 23% was associated with postoperative wound infection. It showed best sensitivity to vancomycin.
  
  
  CONCLUSIONS
  Staphylococcus aureus and E. coli were common causative agent of postoperative infections and puerperal sepsis.
authors.affiliation: Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Iffat Javed
authors.initials: IJ
authors.lastname: Butt
authors.forename: Saba
authors.initials: S
authors.lastname: Khan
authors.forename: Sobia
authors.initials: S
authors.lastname: Butt
authors.forename: Shereen
authors.initials: S
authors.lastname: Bhutta
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D011645:Puerperal Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents